A 54-year-old Man with HIV-Associated Nephropathy
DOI:
https://doi.org/10.38035/ijphs.v4i2.2157Keywords:
HIVAN, ESRD, ARVAbstract
HIV-associated nephropathy (HIVAN) is a renal parenchymal disease that occurs in individuals infected with HIV. HIVAN is commonly found in patients with severe immunocompromise, particularly with CD4 counts <200, although it may also occur during primary HIV infection. HIVAN is rarely reported in Asian countries. In this case, we report a patient with progressively worsening renal function due to HIVAN. A 54-year-old man with a history of HIV presented with fatigue, fever, weight loss, diarrhea, and poor adherence to antiretroviral therapy, leading to a diagnosis of HIVAN. This patient presented with fatigue, fever, weight loss, and diarrhea. Urinalysis showed proteinuria, and renal ultrasonography revealed enlarged, echogenic kidneys. Progressive daily increases in BUN and serum creatinine during hospitalization indicated deteriorating renal function. These findings are consistent with HIVAN. HIVAN is a serious renal disease that may occur in individuals with HIV. It is a known cause of chronic kidney disease and end-stage renal disease (ESRD). Renal function screening in HIV patients is essential to prevent progression to ESRD.
References
Adedeji TA, Adedeji NO, Adebisi SA, Idowu AA, Fawale MB, Jimoh KA. Prevalence and pattern of chronic kidney disease in antiretroviral-naïve patients with HIV/AIDS. Journal of the International Association of Providers of AIDS Care (JIAPAC). 2015;14(5):434–40.
Alfano G, Cappelli G, Fontana F, Di Lullo L,Di Iorio B, Bellasi A, et al. Kidney-disease in HIV infection. J Clin Med. 2019 Aug; 8(8):1254.
Chloe Symeonidou, dkk. Imaging and Histopathologic Features of HIV-related Renal-Disease. RadioGraphics. 2008; 28:1339–1354
Herman ES, Klotman PE. HIV-associated nephropathy:epidemiology, pathogenesis, and treatment. Semin Nephrol. 2003 Mar; 23(2):200–8.
Heron JE, Bagnis CI, Gracey DM. Contemporary issues and new challenges in chronic kidney disease amongst people living with HIV. AIDS Res Ther. 2020 Dec;17(1):1–13.
Hiv-Associated Nephropathy (Hivan) In A Patient with Low Viral Load Al-Suraimi, Anas Et Al. Chest, Volume 164, Issue 4, A2674 - A2675.
KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S): S117–S314.
Lai CF, Huang JW, Lin WC, Hung CC, Chu TS. Human immunodeficiency virus-associated nephropathy. J Formos Med Assoc. 2006 Aug;105(8):680-4. doi: 10.1016/S0929-6646(09)60169-8. PMID: 16935771.
Naicker S, Rahmanian S, Kopp JB. HIV and chronic kidney disease. CN. 2015;83 (2015) (S1):32–8.
Pedoman Nasional: Tatalaksana Klinis Infeksi HIV dan Terapi Antiretroviral. Jakarta: Kementrian Kesehatan Republik Indonesia; 2011. h 9-10
Rivera FB, Ansay MFM, Golbin JM, Alfonso PGI, Mangubat GFE, Menghrajani RHS, Placino S, Taliño MKV, De Luna DV, Cabrera N, Trinidad CN, Kazory A. HIV-Associated Nephropathy in 2022. Glomerular Dis. 2022 Oct 24;3(1):1-11. doi: 10.1159/000526868. PMID: 36816427; PMCID: PMC9936764.
Ross MJ, Klotman PE, Winston JA. HIV-associated nephropathy: case study and review of the literature. AIDS Patient Care STDS. 2000 Dec;14(12):637-45. doi: 10.1089/10872910050206559. PMID: 11119430.
Ross, Michael dan Klotman, PE. HIV Associated Nephropathy. AIDS. 2004;18(8):1089-99
University of Nebraska Medical Center. Antimicrobial Dosing Guidelines for Adult Patients with Renal Dysfunction. [Internet]. 2021 [cited 2025 May 14]. Available from: https://www.unmc.edu/intmed/_documents/id/asp/dose-nm-anti-infective-renal-dosing-guidelines.pdf
U.S. Department of Veterans Affairs. (n.d.). HIV wasting syndrome. Diakses pada 09 April 2025, dari https://www.hiv.va.gov/patient/diagnosis/oi-wasting-syndrome.asp
U.S. Department of Health and Human Services. Drug Characteristics Tables: Renal and Hepatic Insufficiency. ClinicalInfo HIV.gov. [Internet]. 2023 [cited 2025 May 14]. Available from: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult-and-adolescent-arv/drug-characteristics-tables-renal-hepatic-insufficiency-full
Vina Septiani, N., & Sudhana, I. (2013). A CASE OF RENAL DISEASE IN HIV INFECTED PATIENT. E-Jurnal Medika Udayana, , 1899-1909. Retrieved from https://ojs.unud.ac.id/index.php/eum/article/view/7031
Vina Septiani, N. M., & Sudhana, I.W. (2013). A Case of renal disease in HIV infected patient. E-journal Medika Udayana, 2(11), 1899-1909. Diakses pada 10 April 2025, dari https://ojs.unud.ac.id/index.php/eum/article/view/7031
Wijanarko MSP. Gangguan Ginjal pada Pasien HIV Dewasa. J Kdokt Meditek. 2021;27(3): 263-272. Available from: http://ejournal.ukrida.ac.id/ojs/index.php/Meditek/article/view/2033
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